The cardinal system of gallstones is billary colic. It is a moderately severe crescendo type pain in the right upper quadrant of the abdomen radiating to the back and right shoulder. The pain is usually steady and may not be colicky. The pain often occurs after indigestion of fatty meals. The pain classically lasts for 24 hours. Fever and symptoms are unusual. A pain lasting longer than 4 hours or associated with systemic symptom indicate development of acute cholecystitis. However, dyspepsia may co-exist with gallstones.
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